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Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005971","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Effective heart failure (HF) prevention requires early identification of high-risk individuals, yet population-wide stratification remains difficult. We evaluated whether deep learning using single-lead (lead I) electrocardiograms (ECGs), obtainable from medical systems and wearables, enables population-scale risk assessment. We developed AI-HF to estimate incident clinical HF risk using UK Biobank (UKB) data, validating in the prospective SHIP-START and SHIP-TREND cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The analysis included 31 740 UKB participants (median age 64, 5.2 year follow-up, 243 events), 3025 SHIP-START participants (age 50, 15 year follow-up, 166 events), and 1342 SHIP-TREND participants (age 51, 9 year follow-up, 84 events). Participants with prevalent HF were excluded. Performance was evaluated at a harmonized 5-year prediction horizon. C-indices for incident clinical HF were 0.693 [95% confidence interval (CI) 0.654\u20130.732] in UKB, 0.715 (0.652\u20130.777) in SHIP-START, and 0.791 (0.749\u20130.833) in SHIP-TREND. Hazard ratios per standard deviation increase in AI-HF output were 1.67 (1.56\u20131.79), 1.43 (1.25\u20131.65), and 1.46 (1.34\u20131.59), respectively (all P &amp;lt; 0.001). Adding biometric variables improved discrimination modestly (C-indices: 0.714, 0.718, and 0.77).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Across cohorts, AI-HF identified individuals at elevated 5-year incident clinical HF risk using single-lead ECGs. Given the ubiquity of wearables, this method may enable population-scale assessment to support targeted prevention and early intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztag099","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:22:48Z","timestamp":1782127368000},"source":"Crossref","is-referenced-by-count":0,"title":["Deep learning analysis of single-lead electrocardiograms enables pragmatic heart failure risk assessment in the general population"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0343-0562","authenticated-orcid":false,"given":"Meraj","family":"Neyazi","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martini Str 52, 20246 Hamburg ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site North , Potsdamer Str 58, 10785 Berlin ,","place":["Germany"]},{"name":"Department of Genetics, Harvard Medical School , 77 Avenue Louis Pasteur, Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan P","family":"Bremer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martini Str 52, 20246 Hamburg ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site North , Potsdamer Str 58, 10785 Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Brederecke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martini Str 52, 20246 Hamburg ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site North , Potsdamer Str 58, 10785 Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius S","family":"Knorr","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martini Str 52, 20246 Hamburg ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site North , Potsdamer Str 58, 10785 Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4595-1531","authenticated-orcid":false,"given":"Ferdinand","family":"Seum","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martini Str 52, 20246 Hamburg ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site North , Potsdamer Str 58, 10785 Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Reinbold","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martini Str 52, 20246 Hamburg ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site North , Potsdamer Str 58, 10785 Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9336-9039","authenticated-orcid":false,"given":"Stefan","family":"Gross","sequence":"additional","affiliation":[{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site North , Potsdamer Str 58, 10785 Berlin ,","place":["Germany"]},{"name":"Department of Internal Medicine B, University Medicine Greifswald , Fleischmann Str 10, 17489 Greifswald ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6210-349X","authenticated-orcid":false,"given":"Dora","family":"Csengeri","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martini Str 52, 20246 Hamburg ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site North , Potsdamer Str 58, 10785 Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6488-2362","authenticated-orcid":false,"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martini Str 52, 20246 Hamburg ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), 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